How to avoid groin injuries in soccer


30.09.2021 Reading time: 3 min

A guest contribution from our expert Lasse Ahl

Disclaimer: The following text and its contents are not a medical indication. If you suffer from an injury, please consult a medical professional before performing any of the exercises listed below.


The muscle group, which seems almost mystical in football circles, still raises questions even among proven experts. So it's no wonder that players who suffer from complaints in the groin region often lose the overview.

In the book "Return to Play in Football" a nearly 1,000-page scientific summary of the most common injuries in football and their rehabilitation, an entire subchapter is devoted to the groin.

In "Return to Play in Non-operative Hip/Groin Pain," it is subdivided even more subtly. As with many pathologies, this is because groin injuries can be favored by a variety of partially interrelated (multifactorial) risk factors.

Now, why an athlete gets "problems" in the groin is often diffuse and highly individual. For illustrative purposes, two famous examples may be mentioned. Jerome Boateng and Marco Reus, exceptional athletes in their own right, have had an almost endless list of injuries in the course of their careers.

This list is dominated by "muscular problems in the adductor area".

If we look at both players, we notice that they are fundamentally different in their body geometry. On one side is Jerome Boateng, 10cm taller than the Bundesliga average, weighing just under 90kg. On the other side is Marco Reus, just under 20kg lighter (1.80m & 71kg).

Without going into too much anatomical depth, you can already see from the two players that the solution for "groin complaints" cannot be summarized in a simple causal chain.


As mentioned above, the "Non-surgical hip and groin pain" are subdivided again. Since the anatomical complexity of the hip and groin area seems to be possibly the reason for the frequent occurrence of mutually dependent maladaptations, we limit this blog entry to a specific subgroup: the adductors.


The risk factors

The adductors are involved in all major movements in the game of football, whether running, sprinting, jumping, changing direction, or kicking. Since football thrives primarily on sprinting, changing direction and abrupt turns, the demands on these relatively long, thin muscles are many. The forces acting on them are often many times greater than their own body weight.

According to a 7-year prospective survey conducted by UEFA, adductor-related injuries account for approximately 64% of all hip and groin injuries.

Within adductor pathologies, we can distinguish three categories:

  • Hip adductor strains

  • Hip adductor tendinopathies

  • Hip adductor tears


If you have read this far, you might conclude that the adductors are a very fragile and breakable construct that is best wrapped in "absorbent cotton".

This is not so.

Like the entire human body, the adductors adapt to stresses.

So the real question, once again, is how much of what is too much?

In fact, the risk factors of adductor pathologies are quite diverse:

  • Anatomical conditions (size, joint positions (alignment), abnormalities).

  • Overweight

  • age

  • Gender

  • Previous adductor injuries

  • Strength differences from L to R

  • Multiple overload, load tolerance (e.g. load management v.a. eccentric overload)

  • Strength deficit in trunk and lower body


Now for the good news.

Many of the risk factors are controllable.

Ekstrand et al (2011) identified decreased strength and mobility in the hip complex, along with the prevalence of past adductor injuries, as "THE" risk factors of (re)adductor injury.

So why is this good news?

For the most part, decreased strength and mobility means that these are so-called conditional deficits, and thus are modifiable. If we look again at the above risk factors, we notice that right away 3 of the 4 modifiable (obesity would be #4) risk factors could be remedied by specific training.


Rehabilitation & Prävention

Aus den drei Kategorien behandeln wir im Folgenden nur noch die Zerrungen und in kleinen Teilen die Tendinopathie.

Wer unter einer akuten Adduktoren-Zerrung leidet der fällt im Schnitt zwischen 4 – 6 Wochen aus. Die Ausfallzeit beschreibt hier jedoch lediglich die Abwesenheit im Mannschaftstraining und dem Spielbetrieb.

Wer unter einer Tendinopathie einer der Adduktorensehnen laboriert, der fällt sogar ca. 9 Monate aus.

Grundsätzlich unterscheiden sich beide Verletzungen nicht nur in der Art des betroffenen Gewebes (Muskelbauch vs. Muskel-Sehnen-Übergang), sondern ebenfalls in der Art und Weise der Behandlungszeit. Darüber hinaus kann sich eine Tendinopathie aus einer unbehandelten Adduktoren-Zerrung heraus entwickeln.

Wie bei vielen muskulären Verletzungen ist der Rat „Mach einmal Pause“ in seiner Generalität genau der Falsche.

Ja, es sollten Belastungen limitiert werden, die einen starken mechanischen Reiz auf die bereits verletzte Struktur ausüben. Also Laufen, Sprinten, Springen, Schießen und Richtungswechsel, demgemäß all das, was in einem Fußballspiel gemeinhin vorkommt.

Generell lässt sich, anhand der Evidenz ableiten, dass diejenigen Athleten*innen früher auf den Rasen zurückkehren, die früher mit einer aktiven Rehabilitation anfangen.

Wichtig zu wissen ist allerdings, was man in den bestimmten Phasen machen kann und was nicht.

Bereits aus anderen Reha-Blog-Einträgen ( Achillessehnenverletzung & Schienbeinkantensyndrom) bekannt sind die Begriffe des „Load Managements“ und des „Pain Monitorings“. Beide Steuerungseinheiten finden auch in der aktiven Hüftadduktorenrehabilitation Anwendung.


At best, load management should be done with trained professionals.

In the sport of football, the term "load management" is often used, but for the most part it is not entirely clear to the layperson what it actually means. In short, it is the planning of training and break times depending on factors such as load scope, intensity, frequency and individual work capacity. In addition, in the case of a structural injury, there is also the fact that we should respect the tissue healing phases.

Nevertheless, in the case of a groin strain, for example, we can already do more than one would think in the early stages of the injury.

As already touched upon, in the acute phase, high mechanical stimuli should be avoided. In this early phase of the injury (here: strain), light, cyclical movements are recommended, which cause little stress to the tissue and promote blood circulation.

Active rehabilitation can be started about 2-7 days after the injury (depending on the pain sensation). If the pain sensation allows it, one can also start isometric (holding) exercises during this period, in order to maintain or even increase the strength level of the affected muscles. In addition, isometric exercises can relieve pain in some people.

From the second week, dynamic exercises can be implemented, of course in consultation with the professional staff and the patient's own pain perception. If the movements still cause significant pain in the second week, or become persistent after the training (up to approx. 48 hrs. afterwards), then leave the ego at the door and take a step back again. Rehab is a marathon, not a sprint.

Estimated from week 3 on, you can usually start with some casual running training. The further steps like jumping, sprinting, change of direction and team training should be accompanied by experts*. A "return to play" test would be the gold standard here.


Disclaimer for this article

At this point we would like to leave another, final disclaimer. All statements regarding specific timing and exercise implications have been compiled by us based on research and experience.

They are neither fixed nor beyond any doubt. There are players who can start running and sprinting again after 7 days post-distraction. There will be players who can only return to such speed spectra after 4-5 weeks.


5 exercises for or to protect against groin injuries

Adductor Rock Back

You start in a kneeling position and spread one leg outward, supporting yourself with your hand on the floor.

Bringing your free arm under your torso, you first turn in. Then turn up by bringing your arm upward.

Repeat this exercise on both sides.


Copenhagen Hold

In this exercise, you perform a side plank on an elevation - benches, chairs or plyoboxes are particularly suitable for this.

Your upper leg rests on the box, while the free leg is lifted from the floor.

Repeat this exercise on the other side.


Bulgarian Squat

You start with one foot on a box or chair. 

Then bend your front leg and extend it again. Ensure a stable upper body position and controlled flexion-extension movements.

Repeat this exercise on the other side.


Copenhagen Floor Elevation

Start the exercise lying on your side. Make sure your elbow is under your shoulder.

Then extend your upper leg and put tension on your adductors. Now bring your lower leg forward and bring it high and low.

Repeat this exercise on the other side as well.


Skater Jump

With skater jumps you jump from left to right. Land in a controlled manner and then explosively jump back to the side.

Make sure your upper body is stable and jump explosively from side to side.


About the author

Our author Lasse Ahl (33) has been actively playing soccer himself since he was 11 years old, and also does additive strength training as well as cycling, running and skiing.

He is a sports scientist (M.A.) at the University of Göttingen and has been working for several years in the university sports gym and at university sports.

Since 2017, he has also been the Academy Education Director responsible for the education and training of exercise instructors at the University of Göttingen in the areas of exercise science and basic physiology & anatomy.



Serner et al. (2020) Return to Sport After Criteria-Based Rehabilitation of Acute Adductor Injuries in Male Athletes

Volker Musahl, Jón Karlsson, Werner Krutsch, Bert R. Mandelbaum, João Espregueira-Mendes, Pieter d'Hooghe (2018) Return to Play in Football An Evidence-based Approachs